PubMed HealthSearch

Biomedical subjects

G N Weiss

Publications and source records attributed to G N Weiss.

14 recordsLinked to original sources

Outcomes of lower extremity amputations.

In an effort to identify variables that could be used to predict outcomes of amputation, a cohort of 97 veteran amputees with a median age of 64 years who underwent 155 lower extremity procedures during 1984 was followed for 15 months. A high incidence of postoperative complication, revision, and mortality with poor quality of life confirm the serious prognosis of these individuals. Regression analyses indicated that peripheral vascular disease and prolonged preoperative hospitalization were associated with complications. Preoperative gangrene and peripheral vascular disease were associated with the need for revision. Complications, a low body mass index, and multiple diseases were related to death. Those with multiple diseases and extensive atherosclerosis were less likely to walk. Ability to perform activities of daily living was the most important predictor of quality of life. Patients at higher risk for these adverse outcomes need to be identified early in their hospital stay. The involvement of the patient or his or her surrogate in decisions regarding the course of treatment and the level of amputation is essential.

Activities of Daily Living

Neonatal circumcision.

Because of an economically motivated study, there has been an attempt to shift insurance dollars from neonatal circumcision to neonatal intensive care. Negative comments regarding the advisability of early circumcision have created confusion for both physicians and parents. Neonatal circumcision is the most common surgical operation in the United States, with probably fewer complications than any other. I believe this valid prophylactic procedure is falling victim to an unwarranted bias.

Attitude

Hormonal therapy and cholelithiasis.

This report is to alert the abdominal surgeon to a new factor responsible for a rising incidence of cholelithiasis in the younger woman. The cause of cholelithiasis has been explained on the basis of biochemical changes with mechanical obstruction. The role of estrogen-progesterone elevation in pregnancy with associated hypercholesteremia is well-known. Little known are reports (more common in non-American literature) that female hormones effect a sluggishness of gallbladder function. Thus, a chemical change with a functional type of obstruction in the biliary tree predisposes toward cholelithiasis. A survey of 1346 cholecystic operations from 1969 through 1973 showed the expected greater incidence in women. Women under 40 years of age who received hormonal medication were younger when operated upon than a comparable group not receiving hormonal therapy. The incidence of gallbladder disease in young women using hormonal therapy should be expected to increase in the coming years. Cholelithiasis should be suspected in the young female taking birth control medication. X-ray study is indicated and early surgery is desirable to prevent morbidity, mortality and the complications of cholecystic disease.

Adult